DK E001

Association of
Danish unemployment
Insurance Funds /
Periods of Insurance
Danish Act No. 114 of 24 March 1970 as amended

INFORMATION ON THIS DOCUMENT

This document is applicable to members of the Danish unemployment insurance who need to get their insurance periods in another EEA country confirmed.

Under Danish law, the right to early retirement (efterløn) is conditional on periods of unemployment insurance of up to 30 years.

Number of attachments / 0
Date sent (yyyy-MM-dd)
Sending institution:
Country code / DK
Institution code
Institution name
Street
Town
Postal code
Region
Country / Denmark
Phone
Fax
Email
Receiving institution:
Country code
Institution code
Institution name
Street
Town
Postal code
Region
Country
Phone
Fax
Email
1. Case numbers
1.1 Case number of the sending institution1
1.2 Case number of the receiving institution2
2. Person
2.1 Person3
2.1.1 Family name(s)
2.1.2 Forename(s)
2.1.3 Birth date
2.1.4 Sex
Female Male Unknown
2.1.5 Family name(s) at birth
2.1.6 Forename(s) at birth
2.1.7 If you have the Personal Identification Number of the person, please fill in the following:
Identification of the person with Personal Identification Number
2.1.7.1 Personal identification number in the sending institution
2.1.7.2 Personal identification number in the receiving institution
2.1.8 If you do not have the Personal Identification Number of the person, please fill in the following:
Identification of the person, without Personal Identification Number
2.1.8.1 Place of birth4
2.1.8.2 Father family name at birth5
2.1.8.3 Mother family name at birth6
2.1.8.4 Forename of father
2.1.8.5 Forename of mother
2.2 Additional information on the person
2.2.1 Nationality7
3. Reference period
3.1 Start date (yyyy-MM-dd)
3.2 End date (yyyy-MM-dd)
4. Period of insured employment or self-employment
4.1 Period
4.1.1 Start date (yyyy-MM-dd)
4.1.2 End date (yyyy-MM-dd)
4.2 Type
Employment
Self-employment
5. Period of non-insured employment or self-employment8
5.1 Period
5.1.1 Start date (yyyy-MM-dd)
5.1.2 End date (yyyy-MM-dd)
5.2 Type
Not insured employment
Not insured self-employment
6. Sickness period treated as insurance period
6.1 Start date (yyyy-MM-dd)
6.2 End date (yyyy-MM-dd)
7. Maternity period treated as insurance period9
7.1 Start date (yyyy-MM-dd)
7.2 End date (yyyy-MM-dd)
8. Deprivation of liberty period treated as insurance period
8.1 Start date (yyyy-MM-dd)
8.2 End date (yyyy-MM-dd)
9. Education period treated as insurance period
9.1 Start date (yyyy-MM-dd)
9.2 End date (yyyy-MM-dd)
10. Military period treated as insurance period10
10.1 Start date (yyyy-MM-dd)
10.2 End date (yyyy-MM-dd)
11. Other period treated as insurance period
11.1 Period
11.1.1 Start date (yyyy-MM-dd)
11.1.2 End date (yyyy-MM-dd)
11.2 Type
Period of voluntarily continued insurance
Other period treated as a period of insurance
Compensation for vacation not taken
Please fill in the following if "Type" = "Other period treated as a period of insurance" :
11.3 Other activity
12. Period receiving unemployment benefits11
13.1 Period
12.1.1 Start date (yyyy-MM-dd)
12.1.2 End date (yyyy-MM-dd)
12.2 Institution code12
Signature of the sending institution
Date
Signature / Stamp

DK E001 v 1.0 3.2013 AK-Samvirke